Description of the modified vestibular incision subperiosteal tunnel access (m-VISTA) technique in the treatment of multiple Miller class III gingival recessions: a case series

Aitziber Fernández-Jiménez, Ruth Estefanía-Fresco, Ana-María García-De-La-Fuente, Xabier Marichalar-Mendia, Luis-Antonio Aguirre-Zorzano, Aitziber Fernández-Jiménez, Ruth Estefanía-Fresco, Ana-María García-De-La-Fuente, Xabier Marichalar-Mendia, Luis-Antonio Aguirre-Zorzano

Abstract

Background: Gingival recession is a common finding in the adult population. It is considered a challenge for clinicians to obtain a complete root coverage of Miller class III recession. The aim of this case series was to assess the outcomes achieved with the use of modified VISTA technique (m-VISTA) in patients having multiple Miller class III recessions after 6 months.

Methods: Ten patients (six women and four men; mean age: 53 years), who showed multiple Miller class III recessions (depth ≥ 2 mm) and who met the established inclusion and exclusion criteria, were treated by postgraduate students with the use of m-VISTA technique.

Results: A total of 38 recessions were performed. The recessions were mainly located in the mandible (80%), which included six molars. The mean baseline recession was 3.12 mm. Post the intervention, a mean root coverage of 58.72% was achieved, with complete root coverage observed in 29% of the recessions.

Conclusions: m-VISTA may offer several advantages in the treatment of Miller class III gingival recession. Nevertheless, more clinical trials with a longer follow-up period are needed to arrive at a concrete conclusion about its advantages.

Trial registration: NCT03258996. Data registration: 08/18/2017.

Keywords: Connective tissue graft; Gingival recession; Mucogingival surgery; Periodontal plastic surgery.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Initial situation. b After the preparation of the denuded root surface and the placement of composite in the interproximal sites, a single vertical incision in the mucosa and intracrevicular incisions were performed, preparing a full-thickness tunnel and raising the papillae. c The CTG harvested from the palate using the UPV/EHU technique and its dimensions increased with the expanded mesh CTG procedure. d After the placement of CTG through the vertical incision, vertical double-crossed sutures were performed, coronally tractioning the tunnel-graft-papillae complex as well as the single interrupted sutures in the vertical incision. e 14 days of postoperative healing
Fig. 2
Fig. 2
Initial situation and healing at 6 months after surgery
Fig. 3
Fig. 3
Diagram of the mean post-surgical pain experienced by patients at different time-points

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